Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $44.12 / $84.60 / $251.77	Facility		$44.12	$84.60	$251.77
Aetna Facility/Professional Facility Modifier 50 Low / Median / High Price $41.30 / $59.54 / $268.47	Facility	50	$41.30	$59.54	$268.47
Aetna Facility/Professional Facility Modifier 52 Low / Median / High Price $14.97 / $32.79 / $88.24	Facility	52	$14.97	$32.79	$88.24
Aetna Facility/Professional Professional Modifier Low / Median / High Price $29.93 / $67.40 / $254.52	Professional		$29.93	$67.40	$254.52
Aetna Facility/Professional Professional Modifier 50 Low / Median / High Price $99.75 / $280.50 / $600.00	Professional	50	$99.75	$280.50	$600.00
Aetna Facility/Professional Professional Modifier 52 Low / Median / High Price $14.79 / $22.06 / $66.84	Professional	52	$14.79	$22.06	$66.84
Anthem BCBS Facility/Professional Facility Modifier Low / Median / High Price $1,139.00 / $2,479.00 / $4,441.52	Facility		$1,139.00	$2,479.00	$4,441.52
Anthem BCBS Facility/Professional Professional Modifier Low / Median / High Price $45.62 / $104.84 / $219.54	Professional		$45.62	$104.84	$219.54
Anthem BCBS Facility/Professional Professional Modifier 50 Low / Median / High Price $68.43 / $162.09 / $342.54	Professional	50	$68.43	$162.09	$342.54
CareSource Facility/Professional Facility Modifier Low / Median / High Price $30.32 / $45.84 / $45.84	Facility		$30.32	$45.84	$45.84
CareSource Facility/Professional Professional Modifier Low / Median / High Price $45.68 / $65.91 / $101.89	Professional		$45.68	$65.91	$101.89
Cigna Facility/Professional Facility Modifier Low / Median / High Price $126.16 / $147.41 / $237.79	Facility		$126.16	$147.41	$237.79
Cigna Facility/Professional Professional Modifier Low / Median / High Price $58.30 / $105.19 / $175.93	Professional		$58.30	$105.19	$175.93
DeanCare Facility/Professional Facility Modifier Low / Median / High Price $29.93 / $48.41 / $94.62	Facility		$29.93	$48.41	$94.62
Medica Facility/Professional Facility Modifier Low / Median / High Price $34.97 / $77.22 / $1,756.00	Facility		$34.97	$77.22	$1,756.00
Medica Facility/Professional Facility Modifier 50 Low / Median / High Price $1,102.60 / $1,102.60 / $1,102.60	Facility	50	$1,102.60	$1,102.60	$1,102.60
Medica Facility/Professional Professional Modifier Low / Median / High Price $54.12 / $142.46 / $303.56	Professional		$54.12	$142.46	$303.56
Molina Facility/Professional Professional Modifier Low / Median / High Price $43.21 / $95.07 / $150.12	Professional		$43.21	$95.07	$150.12
Prevea360 Facility/Professional Facility Modifier Low / Median / High Price $29.93 / $48.41 / $94.62	Facility		$29.93	$48.41	$94.62
Quartz Facility/Professional Professional Modifier Low / Median / High Price $73.22 / $109.92 / $162.58	Professional		$73.22	$109.92	$162.58
Quartz Facility/Professional Facility Modifier Low / Median / High Price $189.20 / $189.20 / $189.20	Facility		$189.20	$189.20	$189.20
Quartz Facility/Professional Facility Modifier 52 Low / Median / High Price $116.25 / $116.25 / $116.25	Facility	52	$116.25	$116.25	$116.25
Quartz Facility/Professional Professional Modifier Low / Median / High Price $60.21 / $202.86 / $356.96	Professional		$60.21	$202.86	$356.96
Security Health Facility/Professional Professional Modifier Low / Median / High Price $109.86 / $180.82 / $270.69	Professional		$109.86	$180.82	$270.69
United Facility/Professional Facility Modifier Low / Median / High Price $1,034.00 / $1,423.00 / $2,202.90	Facility		$1,034.00	$1,423.00	$2,202.90
United Facility/Professional Professional Modifier Low / Median / High Price $54.00 / $131.61 / $227.24	Professional		$54.00	$131.61	$227.24